Individual
KATHERINE PENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, AGNP-C
Contact information
Practice address
1670 CLAIRMONT RD, DECATUR, GA 30033-4004
(404) 321-6111
Mailing address
1501 CLAIRMONT RD APT 328, DECATUR, GA 30033-4602
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
RN289981
GA
363LP2300X
Primary Care Nurse Practitioner
RN289981
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN289981
APRN LICENSE
GA
Enumeration date
03/26/2021
Last updated
03/26/2021
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